Healthcare Provider Details

I. General information

NPI: 1881168672
Provider Name (Legal Business Name): KUGLER VISION VCS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2019
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17838 BURKE ST STE 100
OMAHA NE
68118-2256
US

IV. Provider business mailing address

17838 BURKE ST STE 100
OMAHA NE
68118-2256
US

V. Phone/Fax

Practice location:
  • Phone: 402-558-2211
  • Fax: 402-558-2212
Mailing address:
  • Phone: 402-558-2211
  • Fax: 402-558-2212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LANCE J KUGLER
Title or Position: PRESIDENT
Credential: MD
Phone: 402-558-2211